摘要目的 探讨能量消耗测定在机械通气重症肺炎患者中的临床应用.方法 比较能量代谢测定系统测出的静息能量消耗(REE)与公式法计算出的基础能量消耗(BEE),分析随时间变化的REE/BEE,从而估算出应激系数.结果 重症肺炎患者机械通气期间REE/BEE为1.07 ～1.11,且无明显变化;序贯器官衰竭估计评分(SOFA)与C-反应蛋白(CRP)逐渐下降.机械通气最后1d呼吸商(RQ)高于第1天.结论 由间接测热法测得静息状态的重症肺炎患者的REE约为BEE的1.1倍,REE/BEE治疗期间无明显改变,可能是由于患者能量摄入增加和一般情况改善导致的.

abstractsObjective To investigate the clinical application of energy expenditure measurement in severe pneumonia patients with mechanical ventilation.Methods The resting energy expenditure (REE) measured by the indirect calorimety metabolic cart and the basal energy expenditure (BEE) calculated by the formula H-B were analyzed and compared,and the time dependent REE/BEE was calculated to estimate the stress coefficient.Results REE/BEE keeps in 1.07 to 1.11 without significant change during the period of mechanical ventilation in severe pneumonia patients with mechanical ventilation.Both sequential organ failure assessment score (SOFA) and blood concentrations of C-reactive protein (CRP) were decreased over time.Respiratory quotient (RQ) on the last intubation day was greater than that on the first day.Conclusions The REE of patients with severe pneumonia in resting state measured by indirect calorimetry is 1.1 times as high as that of BEE.The ratio of REE/BEE was steady without significant change during treatment,it may be due to the concomitant increase of energy intake and improvement in general condition.